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c73c1086-b57f-48d6-a448-b1bdb40967c7 | Factories 108 3 — — Workshops 129 19 1 — Workplaces 212 4 — — Total 449 26 1 — 44 2. DEFECTS FOUND. Particulars. Number of Defects. Number of Prosecutions. Found Remedied Referred to H.M. Ins. *Nuisances under the Public Health Acts:— Want of cleanliness 15 15 — — Want of ventilation 1 1 — — Overcrowding — — — — Want of drainage of floors — — — — Other nuisances 12 12 — — Sanitary accommodation Insufficient — — — — Unsuitable or Defective 10 10 — — Not separate for sexes — — — — Unscreened for Sexes — — — Offences under the Factory and Workshop Acta:— Illegal occupation of underground bakehouse (S.101) — — — — Breach of special sanitary requirements for bakehouses (SS. |
6c6edf6d-e233-4af2-a60a-01da50171859 | 97 to 100) 4 4 — — Other offences (excluding offences relating to outwork which are included in Part 3 of this Report) — — — — Total 42 42 — — * Including those specified in Sections 2, 3, 7 and 8, of the Factory and Workshop Act as remediable under the Public Health Acts. HOME WORK. Four notices were issued to the occupiers of premises in the district where outworkers are employed, who supplied lists twice during the year of six contractors and 24 workpeople engaged on making wearing apparel in their homes. 45 REGISTERED WORKSHOPS. Workshops on the Register (Sec. 131) at the end of the year. Number. (1) (2) Bakehouses (including seven factory bakehouses) 13 Other Workshops 58 Total number of Workshops on Register 71 OTHER MATTERS. Class. Number. (1) (2) Matters notified to H.M. |
346382dd-fc49-4d3a-a86c-cbcdbfd82b1c | Inspector of Factories :— Failure to affix Abstract of the Factor)' and Workshop Act (Sec. 133) 2 Action taken in matters referred by H.M. Inspector as remediable under the Public Health Acts, but not under the Factory and Workshop Acts (Sec. 5) 2 Other — Underground Bakehouses (Sec. 101):— Certificates granted during the year — In use at the end of the year — OUT-WORKERS. The following list shows the nature of the homework carried out in this district by 38 out-workers:— Box Makers 2 Wearing apparel 16 Ties 5 Umbrella makers 2 Life belt covering 10 Boot Repairers 1 Art. Flowers 1 Brush Maker 1 During the year 23 lists of out-workers were received from other Authorities in respect of addresses in Barking. 4 lists were received from employers within the district. In all instances the premises of out-workers were kept in a satisfactory state. 46 HOUSING CONDITIONS. |
c2e395f1-a2a3-4570-b47a-78f49114f625 | Two events of importance occurred during the year, viz., the rehousing of the tenants from the Parsons Row area, and the commencement of building operations in connection with the 198 houses to be erected as the first section of the Upney estate. In regard to the rehousing of displaced tenants from the condemned area it was highly gratifying to find every one of them so eager to move into the new accommodation provided, as this has not been the happy experience of every Local Authority. It was not possible to proceed with the clearance scheme until some fresh accommodation was available for use as a housing decant. Even when provided, it frequently happens that the new accommodation is of such a character that the persons moved from slum property are incapable of taking advantage of it and paying the normal rent. To avoid this the Council was at pains to design such accommodation as would meet the needs of the incoming tenants in every respect,- and what is equally important, was persistent in a demand for a rent such tenants could afford to pay—hence the alacrity to change. |
49d4def0-ce9a-442f-922f-d9e028367ff3 | All this involved considerable time. Further, clearance could only be made in sections and this factor has materially hindered the progress of the rehousing. Prior to the occupation of the new houses, the belongings of the proposed tenants were disinfested, and in some cases destroyed, before occupation was allowed. The wisdom of this precaution was proved by an inspection of the premises after an interval of nine months, when no instance of vermin infestation was discovered. The reaction to their improved conditions by 90 per cent., of the residents has fully justified the Council in its action. 47 It has been the considered aim of the Council in erecting new houses to relieve overcrowding to build these new houses substantially, to equip them with all modern improvements and, nevertheless, to carry out the scheme in such a way that these houses can be let at a rental the proposed tenants are able to afford. |
92739e6a-768c-4267-90c0-99f7a744dac2 | Our unfortunate experience is that many families who are living under overcrowded conditions find it difficult to pay for the accommodation and amenities which are necessary for their numbers, and to meet this difficulty the Council had recourse in its recent schemes to a simplified form of accommodation which it was possible for such families to rent. It is refreshing to find how gladly a large number of persons have responded to the improved environment of their new accommodation, but undesirable tenants are to be found everywhere. Obviously, these tend to gravitate into houses where overcrowding occurs, and the rehousing of these people can only be an economic proposition if close supervision is maintained. Bearing in mind all the circumstances, the general condition of the houses in the district indicates the thorough supervision the sanitary inspectors give, and the fact that every house is provided with separate water supply, sink and w.c. accommodation is very pleasing. In an effort to prevent the decay of houses into slums, owners are continually advised of necessary repairs, but many desired improvements are hindered by financial difficulties. |
70472370-3104-422f-892e-668b5930e92b | 49 SECTION 3. NOTIFIABLE INFECTIOUS DISEASES. The following table shows the number of notifications of infectious disease received during 1928:— TABLE I. Males. Females. Total Total cases rcm'd to Hos. Deaths. |
f48a51fe-f399-4d5e-8892-6e1aec389321 | Small Pox 1 4 5 5† — Scarlet Fever 126 117 243 230* — Diphtheria 46 61 107 104 — Puerperal Septicæmia 2 2 2 — Pneumonia (Acute primary and influenzal & following Measles) 41 33 74 5 23 (All Forms) Erysipelas 16 10 26 4 — Ophthalmia Neonatorum 8 7 15 — — Puerperal Pyrexia — 6 6 — Enteric — 4 4 3 — Anterio Poliomyelitis — 1 1 1 — Totals 238 245 483 354 23 * Includes 28 cases removed to Creeksmouth Isolation Hospital, † These were removed to Orsett. |
a3e593c4-f959-4e7c-a884-705da391f5ed | 50 The following diseases were notifiable in 1928 under the original Infectious Disease (Notification) Act, 1889, and 1899:— Smallpox, diphtheria, relapsing fever, cholera, erysipelas, typhus, plague, puerperal fever, enteric fever, scarlet fever and continued fever. and by Orders or Regulations framed under Section 180, Public Health Act, 1875:— Tuberculosis (all forms), ophthalmia neonatorum, cerebro-spinal fever, acute poliomyelitis, encephalitis lethargica, influenzal pneumonia, acute primary pneumonia, malaria, dysentery, trench fever, and puerperal pyrexia. The Barking Town (Pneumonia) Regulations, 1924, provides for the notification of Pneumonia supervening upon Measles. The total notifications of infectious disease numbered 483. exclusive of tuberculosis compared with 461 the previous year. |
ac4860ac-19bf-40be-aab2-f86e102fc0d6 | During 1928 the number of notifications of tuberculosis (all forms) was 93 compared with 108 in 1927. ->1—5:2 TABLE II. Notifiable Disease. No. of cases notified at age groups. Cases classified according to Wards. Under one year. 1 to 2 years. 2 to 3 years. 3 to 4 years. 4 to 5 years. 5 to 10 years. 10 to 15 years. 15 to 20 years. 20 to 35 years. 35 to 45 years. 45 to 65 years. 1 Over 65 years. Abbey. Gascoigne. Central. Ripple. Longbridge. Westbury. |
a1208a6e-9053-4931-a295-3ff94ace9531 | Small Pox — — — 1 — — 1 3 — — — — 4 1 — — — — Scarlet Fever 1 7 4 10 12 81 62 30 23 — 7 — 32 40 20 38 32 81 Diphtheria 1 3 3 10 9 54 10 6 3 2 — — 20 23 14 12 27 11 Puerperal Septicæmia — — — — — — — — 2 — — — — — — 1 1 — Pneumonia (primary, influenzal and following Measles) 3 14 3 3 3 7 1 7 8 5 12 8 18 18 11 8 8 11 Erysipelas 1 — 1 2 — 1 1 1 1 6 10 2 3 7 6 2 6 |
6f6f2dab-2646-458c-8e07-3e5ea5b4336e | 2 Ophthalmia Neonatorum 15 — — — — — — — — — — — 3 6 2 2 2 — Puerperal Pyrexia — — — — — — — — 3 3 — — 2 2 — 1 1 — Enteric Fever — — — — — 1 1 — 1 1 — — 2 — — — 2 — Anterio Poliomyelitis — — — 1 — — — — — — — — — — 1 — — — Totals 21 24 11 27 24 144 82 53 41 17 29 10 84 97 54 64 79 105 53 TABLE III. Monthly summary of notifications of Scarlet Fever and Diphtheria received during 1928: Scarlet Fever. Diphtheria Total. |
8bb32a47-f042-412d-a7ab-db047e7f0f37 | January 13 8 21 February 8 10 18 March 9 15 24 April 5 9 14 May 3 13 16 June 9 15 24 July 68 4 72 August 17 6 23 September 22 10 32 October 18 7 25 November 44 4 48 December 27 6 * 33 Total 243 107 350 (a) Scarlet Fever.—The number of cases notified was 243 compared with 184 the previous year. No fatal cases occurred. 230 cases were isolated at the local Infectious Hospital, including 28 at Creeksmouth. The average stay of scarlet fever cases in the Municipal Hospital was 31.48 days, compared with 36.5 days in 1927. The longest period of detention was 123 days and the shortest 12 days. Sex.—126 cases were male and 117 female. |
a9bbdd41-bd8d-4586-8c10-ba92481edf8a | (b) Smallpox.—There were five cases of smallpox during the year under review. X They were all of a mild type and the situation was dealt with along orthodox lines. 54 It is a curious thing to see numbers of people waiting about the Town Hall to get their vaccination exemption certificates signed on the same evenings that the Health Committee is meeting to take measures—such as the notification of chickenpox, etc.—for the prevention of smallpox. Our experience in Barking is that smallpox at the present time is a very minor disability and that the disability of vaccination is quite comparable with smallpox itself, in which circumstance the general public, who can hardly be expected to weigh impersonal altruism in the scales against maternal love, can both be understood and appreciated even where their decision may be misguided. |
b1398a10-034c-40c1-940f-4674b359fbc5 | It is also a curious thing in this country that people will swallow excessive amounts of nauseous liquids and other preparations at great personal inconvenience and sometimes to their own detriment, and yet they have an ill-founded antipathy to the more scientific medicaments which can only be efficiently administered through that most dreaded of all sugical instruments—a hollow needle. There is no doubt that drugs in a bottle are looked upon with superstitious awe and the public are not prepared yet to receive the results of much painstaking scientific research where these require anything other than a dose of nasty physic. Objection to vaccination as such is due to superstition, and it cannot be too often emphasised that this is unreasonable and that vaccination does prevent smallpox. |
5530420c-1c59-4526-8eca-ba917d091287 | The best means of carrying out vaccination and the degree of protection it is most desirable to obtain and other questions are certainly before the country for very serious debate, and I do hope these questions will be explored from every possible point of view, and I am happy to believe that whatever may be the public's decision in the future it will be based on information rather than on the ignorance which has hitherto directed the present antipathy to vaccination. That vaccination is not without some danger has been known for a very long time. We are beginning to know exactly what that danger is and perhaps it will be possible to prevent it. |
754d9c00-8a3e-4384-860b-2529612201fa | 55 Whenever such cases arise they get a wide publicity, in which circumstance this danger is exaggerated, and whilst I do not wish to say anything to minimise the reality of this unfortunate aspect of vaccination I do want to say quite frankly that this danger is nothing comparable to the present dangers from traffic, so that to be logical those who are so bitterly opposed to vaccination ought also to promote legislation making it a penal offence for anyone to engage in methods of travel which have been introduced within the last century. I feel sure that the crux of the matter is an economic one and unless we do something to deal with smallpox we shall find that our export commerce is adversely affected, and I am sufficiently sceptical to believe that when once this is realised we shall not hear a lot more against vaccination. (c) Diphtheria.—107 cases were notified, compared with 77 the preceding year. Of cases notified, 104 were removed and treated in the local isolation hospital. No deaths from diphtheria occurred. |
33bf375b-5391-46f3-b3a2-d3985328b57f | The average stay of clinical diphtheria in hospital was 36.08 days, the longest stay being 111 and the shortest 13 days. Sex.—46 cases were male and 61 female. (d) Enteric Fever.—Four cases of enteric fever were notified during the year, 3 of which were removed to hospital. In one case the diagnosis was not confirmed. (e) Puerperal Fever.—Two cases were notified during the year, and both were admitted to hospital. The cases recovered. (f) Puerperal Pyrexia.—Six cases were notified during the year. All of the cases recovered. (g) Erysipelas.—26 cases were notified during the year compared with 30 during 1927. Four patients were removed to hospital. (h) Malaria and Trench Fever.—No cases were notified during the year. |
3a37bb15-3ecc-4e2e-9c55-76d2cde7a420 | 56 (i) Acute Primary and Acute Influenzal Pneumonia.—74 cases were notified during 1928, compared with 111 for the preceding year. Five patients were admitted to hospital. (j Encephalitis Lethargica.—No cases were notified during the year. (II) NON-NOTIFIABLE INFECTIOUS DISEASES. The most important of these are measles, whooping cough and summer diarrhoea. There were no serious epidemics of these diseases, a: d the deaths registered were as follows :— Measles 13 Whooping Cough 6 Summer Diarrhoea 6 Measles and Whooping Cough.—Cases amongst school children are reported to the School Medical Officer by school teachers, attendance officers and nurses, appropriate action being taken as regards exclusion and supervision of contacts. ISOLATION HOSPITAL. The following is the table of admissions, etc., in respect of infectious diseases during 1928 :— Disease. |
9244874c-ab19-44c4-9340-318c2e569c2d | in Hospital January, 1st. 1028. Admitted during the year. Died. Discharged In Hospital Dec. 31st. 1928. Scarlet Fever 20 230 — 222 28 Diphtheria 18 104 — 112 10 Pneumonia 1 5 4 2 — Puerperal Fever — 2 — 2 — Ant: Poliomyelitis — 1 — 1 — Enteric Fever 2 3 — 5 — Erysipelas — 4 — 4 — Miscellaneous — 1 1 — — TUBERCULOSIS. Administrative Arrangements.—Under the Essex County Council (the responsible authority for the treatment of tuberculosis), the Medical Officer of Health of Barking continued as Tuberculosis 57 Officer for the district during the year. |
b0064e9b-ba07-48f3-ac6f-de6c80536bdb | The administrative arrangements for dealing with tuberculosis in the area include :— (a) A dispensary used on two half-days per week, (b) Garden shelters for suitable cases, (c) Sanatorium accommodation for surgical tuberculosis, (d) Sanatorium accommodation for suitable early pulmonary cases, and in some instances the more advanced, (e) Accommodation for a number of bedridden and advanced cases at St. Joseph's Hospice, Hackney, and Liverpool Road Hospital, Islington. The number of notified cases on the register on December 31st, 1928, was 990, compared with 946 for the corresponding period of the preceding year. During the year, 93 notifications were received of all forms of tuberculosis—pulmonary 67, and non-pulmonary 26. Information was received of the removal into the district of four tuberculous persons. Forty-seven deaths of notified cases occurred. |
fcb9b0b9-0fa6-4045-b26e-ac005931e4f5 | Particulars of new cases of tuberculosis notified and of deaths from the disease during 1928 is afforded by the following table :— New Cases. Deaths. Pulmonary. NonPuhnonary. Pulmonary. NonPulmonary. Male. Female Male Female. Male. Female Male. Female. |
d3c1b867-a014-42a4-a686-1f548a040da9 | Under 1 year 1 2 — — — — 1 to 5 years — — 3 3 — — — ' — 5 to 10 years 3 1 4 2 1 — — — 10 to 15 years — 1 2 2 — 1 — — 15 to 20 years 4 4 2 4 1 2 — — 20 to 25 years 3 7 — — 3 5 2 — 25 to 35 years 4 15 — 1 7 7 — — 35 to 45 years 6 5 — — 8 — — 45 to 55 years 6 2 — — 5 1 — — 55 to 65 years 3 2 — — 2 2 — — 65 yrs. |
dc278b0a-26a2-41d1-be6d-2405e1b6b6b0 | & upwards 1 — — — 1 — — Totals 30 37 12 14 27 19 2 — 58 PUBLIC HEALTH (PREVENTION OF TUBERCULOSIS) REGULATIONS, 1925. These regulations, which came into force on July 31st, 1925, give power to a local authority to prevent any person suffering from tuberculosis of the respiratory tract entering upon any employment or occupation in connection with a dairy which would involve the milking of cows, the treatment of milk, or the handling of vessels used for containing milk. Any person who deems himself aggrieved by a requirement under these regulations may appeal to a Court of Summary Jurisdiction, and may, under certain circumstances, be compensated for any damage sustained. In no instance was it found necessary to take action under these regulations. The following are particulars of cases notified under Forms C and D during the year :— Form C. Form D. Pulmonary. Non-Pulmonary Pulmonary. |
04d7b4be-e7a7-4f41-a1d9-5e62ee6d7491 | Non-Pulmonary. Male. Female. Male. Female. Male. Female. Male. Female. 21 37 6 6 15 16 1 6 Forty-eight deaths occurred from tuberculosis (all forms,) 46 of these being pulmonary cases. The number of deaths in institutions was 21. The death rate for tuberculosis (all forms) during 1928 was 1.1, compared with 1.1 for the previous year. 964 attendances were made at the dispensary during the year for the purpose of medical examination, 187 being new cases. Of new cases attending during the year, 61 were subsequently notified as suffering from tuberculosis, 10 had been previously notified, while 4 were inward transfers. 59 The following table gives in tabular form the number of patients removed from the Dispensary Register during the year :— No. on Dispensary Registcr 31-12-27. |
922a98c4-b0fe-4add-abb1-1ef714fb2704 | Numbers removed from the Dispensary Register. Number on Dispensary Register 31-12-28 Died. Left District. Discharged (Non Tb.) Discharged " Cured " Transferred to another Dispensary. etc. Amended Diagnosis Total 494 36 18 90 3 20 3 170 511 At the end of the year, 439 cases on the Dispensary Register were definitely diagnosed as suffering from tuberculosis, whilst in 72 cases the diagnosis still remained in abeyance. REGISTER OF TUBERCULAR PERSONS. This register is, I am of opinion, misleading. It appears to be probable that there are a large number of patients whose names appear on this register who are either definitely cured or in whom it might be possible, after careful scrutiny, to decide that the present evidence does not support the diagnosis. In order that this register may be brought more up to date a very great amount of work will be necessary. |
5fc8f348-daa1-4b23-b58d-bef8e2a8dae5 | This work should be undertaken forthwith, because it is obviously wrong to have a person's name appearing on such a register unless the evidence on which it is so included is conclusive. It is my hope that in my annual report for next year I shall be able to give you an assurance that a large amount of work has been done in this direction, that a large number of people have benefited by having their names removed and that the registers are proportionately a more reliable index of the grave situation which obtains in Barking with reference to tuberculosis. This de-notification of tuberculosis entails not only a large amount of work by your staff, it entails also a large amount of work by the general practitioners who are practising, and who have 60 practised In your area, and I do feel that, called upon as they are to co-operate in this work, they should have some financial remuneration for the work they undertake. |
02cc3f92-ec3d-4b06-b9e4-998db14e9e3c | It is for me to place on record my very high appreciation of the help I have already received in this direction on all hands without which it would have been impossible for this work to have been started, and equally impossible for it to be carried on. AFTER-CARE. Tuberculosis in the great majority of instances is a curable infection provided the patient is seen sufficiently early, undergoes sanatorium treatment and subsequently is able to pass his life under reasonably hygienic conditions. It is with regard to the latter that the activities of the After-care Association in this district particularly exist, consisting inter alia in providing special splints, clothing, boots, nourishment, etc., for necessitous cases and in obtaining, if possible, suitable homes and employment for the tuberculous. ASBESTOSIS. During the year, my work at the Chest Clinic has drawn my attention to a particular disease which, whilst resembling consumption in many ways, is not due, I feel sure, to the germ of Tuberculosis, that is consumption. |
2048d679-0977-4c3e-b42c-bfb67a0bcb6e | As Medical Officer of Health, the possible association of this disease with industrial life has had my attention, and certain steps have been taken in the matter. I am hopeful that our experience in Barking when correlated with that in other similar towns may help to clear up a somewhat difficult and serious problem. 61 SECTION 4. MATERNITY AND CHILD WELFARE. The Council's Scheme under the Maternity and Child Welfare Act, 1918, has been extended during the year. The use of the Artificial Sunlight Clinic, working in co-operation with the Infant Welfare Clinics, continues to be attended with good results. REGISTRATION AND NOTIFICATION OF BIRTHS. By the Registration Act, 1836, all live births must be registered within a period of six weeks. The actual number of live births within the district during the year was 790, the net total of 805 being obtained by adjustment of inward and outward transfers, etc. The births registered included 420 males and 385 females. |
24da3638-c57c-4cf2-8bf4-98f72296526e | There were 20 illegitimate births, or 2.5 per cent, of the total. In comparison with 1927, 95 more births were registered during the year, a rise equivalent to 11.8 per cent. By the Notification of Births Act, all live births and still-births of seven months and over are required to be notified to the Medical Officer of Health within 36 hours. Of the total live births all except 30 or 3.7 per cent, were notified. In addition 4 still births were not notified. The following table gives details of the notifications received By whom notified. Live Birihs. Still Births Medical Practitioners 129 5 Certified Midwives 509 9 Parents and Others 122 — The percentage of still-births was 1.7 62 Of the total live births during the year 470, or 59.5 per centwere attended by midwives, the remainder being attended by medical practitioners. BIRTH RATE. |
1689ac38-c5b2-42cb-adb6-92912cd569cf | The birth rate for the year was 19.7, compared with 16.7 for England and Wales. MATERNITY AND INFANT WELFARE. The Ante-Natal Clinic. The work of the Clinic was carried on as in previous years. _ The attendances during the year were well maintained. The number of primary attendances was 398, compared with 340 for 1927. Reattendances numbered 1,063 in 1928, and 872 during 1927. One hundred and two sessions were held during the year, making an average attendance of 14 mothers per session. Expectant mothers attending the Ante-natal Clinic are drawn from the following classes :— (a) Patients intending to enter the Upney Maternity Ward for. confinement. (b) Thoseengaging with the midwives of the Plaistow Maternity Charity. (c) Patients engaging with private midwives. Post Natal Cases. |
b071b691-70f1-4f0b-a78b-b885203435ed | Seventeen cases attended by midwives were referred by them or by the health visitors for examination at the Ante-natal Clinic owing to the presence of defects following childbirth. 63 MATERNITY WARD. The admission to the Maternity Ward of the Municipal Hospital numbered 200, compared with 221 in 1927. Of these 29 cases were admitted for ante-natal treatment, and 171 for confinement. Corresponding figures for 1927 were 45 cases for ante-natal treatment, and 176 for confinement. (1) Number of cases admitted 200 (29 of which Ante-natal) (2) Average duration of stay 15.3 days (3) Number of cases delivered by :— (a) Midwives 166 (b) Doctors 5 (4) Number of cases in which medical assistance was sought by the midwife with reason for requiring assistance:— (a) Ante-natal 2 (b) During Labour 9 1A.P.H. |
940b4b12-c6d0-463a-aa63-fe8abef7f27f | 1 Prolapse 1 Extended Breech 2 Abnormal Presentations 5 Uterine Inertia l Collapse after 3rd Stage (c) After Labour 14 (d) For Infant — Torn Perineum (5) Number of cases notified as puerperal sepsis with result of treatment in each case 1 (Cured) (6) Number of cases notified as puerperal pyrexia with result of treatment in each case None (7) Number of cases of pemphigus neonatorum None (8) Number of cases notified as ophthalmia neonatorum with result of treatment in each case None (9) Number of cases of " inflammation of the eyes," however slight None (10) Number of infants not entirely breast fed while in the Institution, |
73cf7cee-3b18-4297-ad30-ca5fc761f2c1 | with reasons why they were not breast fed 8 (a) Weakness of mother (suffering from Phthisis) 3 (b) Premature Infant 1 (c) Partially fed—delirate mother 4 64 (11) Number of maternal deaths None (12) Number of foetal deaths (a) stillborn, and (b) within 10 days of birth and their causes—and the results of the post mortem examination if obtainable :— (a) Still-born 6 (b) Within 10 days of birth (Premature twin) 1 PUERPERAL FEVER AND PUERPERAL PYREXIA. On October 1st, 1926, the Public Health (Notification of Puerperal Fever and Puerperal Pyrexia) Regulations, 1926, came into force. |
cd564585-e47d-4f33-99a9-c1e88f737ea7 | These regulations require the notification of puerperal pyrexia (according to the definition given in the regulations), in addition to those cases previously notifiable as puerperal fever under the Infectious Diseases Notification Act, 1899. In a circular accompanying the Regulations, the Minister of Health urges local authorities to exercise the powers conferred on them under the Maternity and Child Welfare Act for provision of facilities for diagnosis, skilled nursing at home, or institutional treatment, if in the opinion of the medical practitioner in charge of the case any one of these is necessary. In accordance with this direction, arrangements have been made by the Council for nursing of the patient at home, or in the isolation hospital as desired. In addition, Dr. A. Kennedy has been engaged as consultant for those cases in which a second opinion is required by the medical attendant. \ Two cases of puerperal fever were notified as compared with 8 in 1927. One case occurred in the Municipal Maternity Ward. |
7c581681-4501-4ae9-8519-8f664e1b7a6e | The patient was isolated immediately on the onset of pyrexia, and no further cases occurred. In addition to the cases of puerperal sepsis, 6 cases of puerperal pyrexia were notified, the confinement in 1 case being attended by a midwife. All the patients recovered. No definite cause of infection was found in any of the cases.. 65 MATERNAL MORTALITY. Two maternal deaths occurred during 1928, the deaths being certified as follows :— (a) Post partum haemorrhage .. .. .. 1 (b) Puerperal Eclampsia .. .. .. .. 1 NEO-NATAL MORTALITY. The number of deaths of infants under four weeks of age was 24, compared with 18 for the previous year in Barking. STILL-BIRTHS. |
161519ed-8084-4873-93b3-52d9a635d6ca | Of the total notifications received under the Notification of Births Act, 18 related to stillborn children, giving a percentage of 1.7 compared with 2.7 in 1927. In addition, 2 Barking women were delivered of stillborn infants in institutions outside the district, so that the total number for the year was 20. Investigation of the health visitors elicited the following information :— (1) Duration of pregnancy :— (a) Less than seven months 1 (b) More than seven months 18 (c) Not elicited 1 (2) Presentation :— (a) Vertex 11 (b) Breech 5 (c) Transverse 2 (d) Not elicited 2 (3) Supposed cause of stillbirth:— (a) Abnormal presentation 1 (b) Overwork — (c) Accident, etc. |
a5d7c4ff-b380-46e8-a5fc-0efce535b274 | 1 (d) Not known 13 (e) Ill health — (f) Shock 2 (4) Occupation of mother :— All the mothers were engaged in household duties at home. In addition, one woman did an occasional day's cleaning elsewhere, whilst two were engaged as clerks. 66 OPHTHALMIA NEONATORUM. There was a decrease in the number of cases of ophthalmia neonatorum, notifications being 15, compared with 24 in 1927. 11 of the cases occurred in the practice of midwives, the remainder being attended by medical practitioners. Cases. Age Group. Notified Treated. At Home. At Hosptl. Vision unimpaired. Vision impaired . Total Blindness. Deaths. |
e86aacf9-8461-4f4a-ab7b-221c41df1b03 | Under 3 weeks 15 15 - 15 - - - The growing appreciation among midwives of the seriousness of the condition and of the value of early treatment makes for a greater readiness on their part to call in medical help to the slighter cases of discharge which • previously may have escaped notification altogether. OPHTHALMIA NEONATORUM REGULATIONS, 1926. These regulations came into force on October 1st, 1926. Under them it is no longer the duty of the midwife to notify cases. In accordance with the rules of the C.M.B. the midwife is under obligation to call in medical aid for any inflammation of the eyes, however slight, and the onus is now with the medical man called in to notify if, in his opinion, the case is one of opthalmia neonatorum. |
bb4a0106-033d-44de-8d96-7245c0699218 | For the effective supervision and treatment of such cases, close co-operation between the Local Supervising Authority and the Local Sanitary Authority is essential, and suggestions are made in a circular accompanying the Regulations as to how this co-operation may best be secured. 67 INFANT AND CHILD WELFARE. Work of the Health Visitors and the Infant Clinics. An analysis of the attendance at the Infant Welfare Centres is given in the following table :— Infant Welfare Centres. Clinic Premises Alex. Centre Movers Lane Total No. of sessions 101 99 100 300 No. of attendances of children under one year:— (a) New cases 175 150 155 480 (b) Old cases 2014 1427 1715 5156 No. |
ff51ba50-0992-4a34-a276-561bba848f6a | of attendances of children 1 to 5 years of age:— (a) New cases 34 39 28 101 (b) Old cases 792 1215 817 2824 Average number of attendances per session 29 28 27 28 No. of sessions attended by medical officers 99 99 99 297 No. of children seen by medical officers (a) Under one year 1493 1082 1188 3763 (b) Over one year 525 778 550 1853 Average number of children seen by medical officer per session 20 18 17 18 The total attendances during the year were 8,561 as compared with 8.592 in 1927. Particulars of the home visits paid by the health visitors is given in the following table:— No. of ante-natal visits 121 No. of first visits to children under one year 777 No. |
eb7c8cdb-22a1-45a1-baf7-f536845c7e2b | of subsequent visits to children under one year:— (a) Attending a Centre 296 (b) Not Attending a Centre 2,897 No. of visits to children 1 to 5 years of age:— (a) Attending a Centre 243 (b) Not Attending a Centre 2,987 No. of special visits in connection with Ophthalmia Neonatorum 29 Ditto Deaths of children up to 3 years of age 64 Ditto Still-births 17 Ditto Puerperal sepsis and Pueperal Pyrexia 6 Ditto Foster Children 27 Other visits (not specified) 283 68 THE PRE-SCHOOL CHILD. Treatment may be obtained for children attending the infant welfare clinics as follows:— Minor Ailments.—Treatment is given at the School Clinic by arrangement with the Education Committee. Dental and orthopaedic treatment, and treatment of septic tonsils and adenoids are available as in the case of school children. |
fdbf29dc-953e-4dc3-87b1-093371a46ef6 | Convalescent Treatment.—This is provided for under the Scheme, and is of value for children suffering from debility following acute illness. FOSTER CHILDREN. All cases of foster children resident in the district are notified by the Guardians to the Medical Officer of Health under the Children Act, Part 1. Twenty-seven notifications were received during the year, and special visits were made by the health visitors to these children, who are also kept under supervision by the Infant Life Protection Visitor. INFANTILE MORTALITY. The total number of deaths of infants during the year was 51, giving an infant mortality rate of 63.3 per thousand registered births, compared with 66.1 per thousand for 1927. ILLEGITIMACY. Twenty illegitimate children were born during the year, and in the same period 6 deaths of illegitimate infants occurred; the infantile mortality rate among these children was therefore 300.0; while that for legitimate infants was 57.3. |
dc9ea87a-c4f0-4282-9d6c-247629d8be8c | DENTAL CLINIC. A general increase in this branch of the work has been taking place, and during 1928 the attendances of expectant and nursing 69 mothers and of children referred from the Maternity and Child Welfare Clinics were as follows:— (1) Number of children treated 102 (2) Number of mothers treated:— (a) New cases 167 (b) Old cases 501 (3) Number of dentures supplied 41 Eighty-one sessions were held. |
61568319-99c3-4962-b9b8-dd078b2e2465 | Here it must be observed that the aim of the Maternity and Child Welfare Service is the prevention of the onset of dental caries in the child, and, for this purpose, the improvement of the health of the mother and of her diet during pregnancy, the encouragement of breast feeding and the use of suitable dietaries for the young child, together with the practice of mouth hygiene, are all factors which must be dealt with by the Maternity and Child Welfare staff, in order to bring about an improvement in the structure of the teeth, and delay in the onset of caries. ORTHOPAEDIC CLINIC. Twenty-two children under school age were referred from the Infant Welfare Clinics or by the local medical practitioners for examination by the Orthopaedic Surgeon during the course of the year, and, in addition, 67 cases attended for re-examination. Three of the children received in-patient treatment at Orthopaedic Hospitals. |
7ed115f1-325f-4275-8164-edf48863cadf | The cases dealt with for the first time during 1928 were referred for the following conditions :— Deformities—Bones and. Joints— (a) Congenital: (i) Abnormal Skull 1 (b) Acquired : (i) Rickets 7 (ii) Genu Valgum 3 11 70 Muscular Deformities— (a) Congenital: (i) Talipes 5 (ii) Torticollis 3 (iii) Hemihypertrophy 1 (iv) Hypotonia 1 (6) Acquired: (l) Pes Planus Valgus 2 12 Paralysis— (a) Congenital: Nil. (b) Acquired : Double Erb’s 1 1 Congenital Deformities—Nil. Total 24 ARTIFICIAL SUNLIGHT CLINIC. The treatment of infants and children under five years of age at the Artificial Sunlight Clinic was continued during 1928. |
6c33a488-49a3-4171-8a4c-8bd3d50890d9 | Cases are referred by the medical officers in charge of the Infant Welfare Clinics, and the children attending are kept under constant medical supervision during their course of treatment. The majority of the children referred for treatment were suffering from early rickets and malnutrition. In addition, cases were referred for the following conditions—chilblains, prematurity, general debility, and anaemia. In all, 81 children received treatment during 1928. One session per week was devoted to these cases, and 757 treatments were given. 71 MEALS TO EXPECTANT AND NURSING MOTHERS. Advantage has been taken during 1928 of this provision under (he Act, 7 necessitous mothers having been provided with dinners as compared with 8 during the previous year. The total number cf dinners supplied was 214. |
0bd967ba-055f-4247-b646-7a7c643606ce | The nutrition of the mother during pregnancy and in the lying-in period has a very important bearing on the well being of the infant, and it is at these times that necessitous mothers are particularly encouraged to avail themselves of the Council's scheme. PROVISION OF FRESH MILK. Particulars of the amounts of wet milk supplied free and at reduced rates to necessitous mothers and children are given in the following table:— No. of pints supplied at reduced price. No. of pints supplied free. Total. Total cost of milk supplied. Council's liability in respect of fresh milk supplied. 1,091 7,825 8,916 £ s. d. £ s d. 123 5 8½ 115 18 7½ PROVISION OF DRIED MILK, Etc. Particulars of the amount of Dried Milk, etc., supplied free and at reduced rates, are as follows :— Ccst Price, (lbs.) |
8bdfeb2a-ab6c-41dc-b783-77366deb17a3 | Reduced Price, (lbs.) Free, (lbs.) Total, (lbs.) Glaxo (Full Cream) 46 8 17 71 Glaxo (Humanised) 822 41 120 983 Ambrosia 531 35 145 711 Cow and Gate 2,562 354 779 3,695 Ostelin 53 — — 53 Lactogol 138 — — 138 Virol 369 - — 369 Parrish’s 106 — - 106 Parraffin 186 186 Malt and Oil 399 399 Vitoleum Cream 795 — — 795 |
c71285fa-85aa-41db-b634-7b184a443159 | BARK 70 Barking Town Urban District Council. THE ANNUAL REPORT OF THE School Medical Officer For the Year 1928 C. LEONARD WILLIAMS. B.Sc., M.R.C.S., L R.C.P., D.P.H. 2 SCHOOL MEDICAL STAFF, 1928 School Medical Officer: C. LEONARD WILLIAMS, B.Sc., M.R.C.S., L.R.C.P., D.P.H. Deputy School Medical Officer: MURIEI J. LOUGH, B.Sc., M.B., B.S., M.R.C.S., L.R.C.P., D.P.H. Orthopaedic Surgeon: B. WHITCHURCH HOWELL, M.B., B.S., F.R.C.S. Radiologist: ANGUS E. KENNEDY, M.R.C.S., L.R.C.P., L.S.A. Dental Surgeon: H. S. SMYTH, L.D.S., R.C.S. (Eng.). |
4360f24d-bd6b-4c63-b24a-605f916b6969 | Masseuse: Miss A. E. FINDLAY, C.S.M.M.G. School Nurses: Miss L. F. SWAIN. Miss F. YOUNG (Dental Nurse). Miss S. E. W. GIBSON. * Clerical Staff: E. W. HILL (Chief Clerk). (Commenced June 1928). E. W. WINCHESTER (Chief Clerk). (Resigned May, 1928). D. G. TONKIN. Miss V. SHEAD. Miss H. NUNN. Miss H. KING. * ½ of Salaries charged to School Medical Service. 3 Barking Town Urban District Council. PUBLIC HEALTH OFFICES, BARKING, ESSEX. April, 1929. To the Chairman and Members of the Local Education Authority. Mr. |
f95eeb75-eb44-4511-baca-b64ac62b60a5 | Chairman, Ladies and Gentlemen, Herewith I beg to submit for your favourable consideration my First Annual Report on the Public Medical Services which are carried on by you. The report deals with the year ending 31st December, 1928. My first year of office has naturally been one of stocktaking and enquiry. I am happy to be able to inform you that the various services you have inaugerated compare, so far as their scope is concerned, more than favourably with the services provided by Local Authorities with resources comparable with your own. You carry out the routine medical examination of children, and children are specially examined for admission to and for report on progress at your Open-air School and your Special Classes at Faircross for mentally-defective children and for children suffering from crippling defects. Your children are further examined before they go to week-end camps and before they go to your summer holiday camp, and other necessary special examinations are carried out. |
5634b657-5920-4b94-ab75-117acdd8151e | You have a Minor Ailment Clinic open every day in the week, and at Faircross there is a clinic for remedial exercises, ultra violet light and other forms of treatment, including electricity and massage advised by your consulting orthopaedic surgeon, Mr. Whitchurch Howell. 4 You have made special arrangements for the surgical treatment of tonsils and adenoids, and, where necessary, your own nurses conduct your little patients to and from the hospital. You have also provided facilities for the cleansing of verminous children and the inspection of the children at your schools for cleanliness is carried out by your nurses regularly three times yearly. In addition to these activities, children's eyes are examined specially to see if and whether they require glasses, and, where necessary, glasses are prescribed and provided. The dental service you have in operation deals comprehensively with oral hygiene. Mr. |
639b34a9-3e5b-4db6-a664-48a7803e995a | Smyth attends every day of the week, and very fortunately he undertakes not only the work for the ' school children, but also for the children under school age, which latter work he carries out under the Maternity and Child Welfare Scheme administered by your Council. Dr. Kennedy, of Plaistow, undertakes on your behalf the X-ray treatment of ringworm, and your officers are in constant touch with the various general hospitals in East London with reference to defective and debilitating conditions that do not come within the scope of your approved schemes. Your officers, in their joint capacity, are able to co-ordinate your work at the Municipal Hospital at Upney with school work, so that the Infectious Fever Hospital is largely a children's hospital, the work at which and the records of which are linked up with the services more directly under your control. |
8664c070-0869-4a7b-8c5b-36ee66f515fb | During the past year an attempt has been made to lay the basis of co-ordination between the various activities which are undertaken under your supervision, and it has been found that the first essential is a more comprehensive system of recording the physical condition of the children under your charge This would entail extra work. It has been found also that with the medical service available you are not deriving the maximum benefit from the various special 5 services you have inaugurated. These naturally have developed since their inception, and time is required not only to cope with their development, but also with their co-ordination. As an illustration of the possibility of further development, I would call your particular attention to the figures given in Table IV, where it will be seen that the number of defects treated during the year at your Minor Ailment Clinic are roughly double those treated last year. This means extra time and extra service. The adverse criticism I have to offer is that you have started a large number of different services, covering a very wide scope of medical activity. |
55335823-e96b-4e4a-ac1a-747bb40e97a4 | These naturally have now attained a state of development where co-ordination is essential if the best use is to be made of them. They have developed too out of proportion to the medical services actually available. Yours very faithfully, C. LEONARD WILLIAMS. 6 ANNUAL REPORT OF THE SCHOOL MEDICAL OFFICER For the Year 1928. (1) STAFF. The Public Health staff is an administrative unit, albeit responsible to two separate committees of the Council. The Medical Officer of Health and the School Medical Officer are one. It is the same with the Assistant School Medical Officer, the Dental Officer and the other officers engaged in the promotion of public health among the school children. |
3b9acdbc-5ace-415a-83f6-652cdefbe6ff | The Ministry of Health was established in 1918 with the object of promoting co-ordination amongst the different Public Health Services, and in writing a report for a year ten years after the inception of the Ministry, it can hardly be out of place to ask seriously if and whether the time has not come when the aims which called the Ministry into existence may not be achieved. The Central Government, in conformity with past precedent, will await a definite lead from Local Authorities and it seems to me reasonable that you should give this necessary lead to the Government by unifying your divided committee work in the supervision of this single Service. During the year under review the question of increasing the medical staff has been entertained. The clerical staff during the year has been increased, Mr. D. Tonkin having been released from the Education Department to work in this department. |
cf717c07-2363-49ac-a96c-03551599ee5e | This has relieved the complaint I made last year that the then present amount of clerical work took more than the ordinary working hours of the then present clerical staff, but such has been the growth of the clerical work that the staff are now again working under pressure. 7 Miss F. Young, the Dental Nurse, resigned in December, 1928. Her resignation takes effect in January, 1929, and steps have been taken to fill the vacancy. (2) CO-ORDINATION. The unified Public Health Staff makes for co-ordination between the various sections of the Public Health Department, and Infant and Child Welfare work is intimately associated with the work amongst children actually attending school. It will be unnecessary for me this year to speak expressly on the question of nursery schools. The matter was discussed at length in my report for the year 1927. I have nothing to add to, and nothing to modify what I said in my report for that year. |
43883ad4-9ef4-4d39-8b47-53fa7d7dbfbf | In speaking of the Maternity and Child Welfare Service and its unification with the other Public Health Services, I wish to include not only the work at the actual Maternity Centres but also the work carried out at your Orthopaedic Clinic and at your Dental Centre, all of which is unified in one department, notwithstanding the fact that for different parts of the work we are responsible to different committees. (3) SCHOOL HYGIENE. Last year it was my duty to call to your attention the need there is for facilities at your schools for the drying of children's clothes and boots. This was previously brought to your notice in the report for the year 1926 and is a matter I have very much at heart. You realise, I know, full well, the necessity for making some provision for drying children's clothes and boots, and I realise the difficulties you experience in obtaining these facilities. |
9d561ce6-38d0-449b-85fd-7c1d40f2e890 | I do, however, feel the time has come when, notwithstanding all the difficulties, a move should be made towards providing an amenity so necessary to the health of the children. Provision of Meals.—The provision of meals in Barking for school children has reached a very high level of efficiency. Meals are prepared at the Municipal Kitchen and are distributed to the 8 Municipal Restaurant and to Faircross School. Not far short of 100,000 meals are thus provided during the year, the far greater proportion of which are mid-day dinners. The problem of catering for children who stay behind at your ordinary school for their mid-day meal does not arise to any significant extent in Barking, except, of course, at Faircross and at Castle School, a'^hough a relatively large number do so stay behind at St. Mary's and St. Ethelburga's, and at St. Joseph's School. In the table given below, details of this matter are set out. School. No. |
e89f2140-c7ac-4bf8-be57-06955683a816 | of children who do not return home for mid-day meal. Whethe facilities exist for heating of children's meals. Whether facilities exist for the drying of children's clothes and boots. Park Modern— 40 Yes Yes C. of E. Boys - No School fires in winter only. Girls - „ „ Infants - „ „ Ripple— Boys - „ „ Girls - „ Infants - „ „ Catholic Mixed 18-20 „ Infants (St. Josephs) 30 Yes „ Gascoigne Boys 8 No „ Girls - „ „ Infants - „ „ Westbury Boys 7 „ Girls - ,, Infants - „ „ North Street- Boys 10 „ „ Girls 1 „ „ Infants - „ „ Castle— 20 Small stove in teachers' private room. „ Faircross- All children stay at school for mid-day meal, the food being supplied from Municipal Kitchen Yes Yes 9 (4) MEDICAL INSPECTION. |
bf7250b9-7cfd-4ee2-b3f6-006f87beec75 | The foundation of a School Medical Service is laid in medical inspection, and every child is submitted to routine medical inspection three times during its school life. These medical inspections have for their object the detection of unrecognised and untreated defects, but they have an objective much wider than this in the classification of all defects, whether recognised or unrecognised, treated or untreated. These routine inspections are a health census of the school population and enable you to determine if and whether your system of education is being carried on without detriment to the health of the children, or, as I prefer to put it, to enable you to determine what physical benefits are conferred on the children by the course of education you provide. From this wider standpoint it is necessary to examine physically healthy children as well as defective children, because otherwise your statistics are likely to represent a state of affairs less favourable than actually exists. |
54d8f120-d896-4ca1-911c-ac142f14227f | The table I am herewith including, which is a modification of Table II B to be found in the appendix to this Report, shows the number of children who have been examined and the number of defective children referred either for treatment or for observation. Entrants. Intermediates Leavers. Specials. Other Routine Examinations. Total. No. of children examined 946 687 581 141 126 2,491 No. referred for treatment 143 115 71 70 22 421 No. referred for observation 184 113 54 53 10 414 Percentage of defective children 34.6 33.2 21.2 87.3 26.9 33.5 10 It will be seen that all along the line there has been an increase in the number of children examined. The old days of rushing these examinations is past. To be worth while they must be done well. |
85d1986a-6617-468b-8408-fcf0b5613d9f | These figures indicate, at least to a certain extent, the reason why during 1928 I have from time to time been constrained to ask you for extra help in carrying out this work. It is refreshing to see that, contrariwise, there has been throughout a decrease in the percentage of defective children found at these examinations. A step such as this is a step in the right direction, and, although I am not going to draw any hasty conclusions, I am glad to think that on the whole the year has shown not only an increased activity in inspection, but also an increased healthiness amongst the children examined. In 1928 the parents of 64.8 per cent, of the children were present at examination, the comparable figures for the three previous years being, in 1927 62.7 per cent., in 1926 60.7 per cent., and in I925 65.5 per cent. |
11ab8833-96b4-4086-8f2e-673581a8f1d5 | The number of children on the school register on 31st December, 1928, was 7,201, compared with 7,001 on 31st December, 1927. During the year, the Medical Officer paid 131 visits to 20 departments for inspection purposes, examinations being conducted throughout the year on the various school premises. Certain cases of defect were, as in previous years, referred to the School Clinic for further examination and treatment. The following table shows the number of children examined at routine and special inspections during 1928, classified according to the schools attended, the number of inspections held in each school and the number of parents or guardians present:- 11 COUNCIL SCHOOLS. School. No. of inspections. Number inspected No. of parents present. Boys. Girls. Park Modern 7 61 58 32 Gascoigne 27 267 292 357 North St. |
d7a5f6ec-2e76-4875-9532-3153683dcf70 | 23 226 209 299 Castle 2 16 27 31 Westbury 22 227 205 323 Ripple 20 184 212 284 Faircross 7 67 59 80 VOLUNTARY SCHOOLS. Church of England 12 125 99 113 Roman Catholic 11 89 87 108 (5) FINDINGS OF MEDICAL INSPECTIONS. Table II on page 44 gives in detail a return of defects found during the course of routine inspection. It will be seen that the number of cases of malnutrition found during these inspections remains practically the same as last year. It may be taken that, generally speaking, a fairly high standard is demanded, and that there are very few children indeed in Barking who are in dire need of something to eat. The part you play in supplying free meals is a small price to pay for such an assurance as this. |
9a7b642d-72c1-4605-b4ee-0cca867300af | (a) Uncleanliness.—With reference to uncleanliness and inspections for this condition, I have to report thai not quite so many children were actually examined as last year and that happily an even smaller number actually and relatively were found unclean. Herewith, in deference to precedent, I am submitting a table of the inspections which have been carried out in the different schools, but, as last year, I wish to make it perfectly clear that the figures cannot be used strictly for comparing school with school as to the efficiency. Different schools have vastly different problems to face, and strict comparison is impossible. There is, however, one fact I wish to stress, and that is that for any boy to have vermin of the head is an utter disgrace to himself 12 if he is of senior school age, and to all those who are in any way in charge of him. |
03af8dc2-5e57-405d-9cd4-18411955ffe4 | A pair of clippers do for a whole family and they are quite cheap, and if parents claim they have not time and opportunity to keep their boys' heads clean by other methods, at least they can keep them clean by keeping their hair clipped short. There is no hardship in proceeding with every .coercive measure you have to enforce absolute cleanliness so far as infestation is concerned amongst boys, and I do not see why every boy with an infested head should not be excluded forthwith and the parents proceeded against, as vou are empowered to do, for his absence from school. You might wish to modify your action by only proceeding to this extremity after a preliminary notice, but so easy is it to keep a boy's head clean that it is difficult to find any justification for it being dirty. School. Dept. No. of Examinations Nits only. |
9c8973fe-ac82-4bd9-ab17-d45ab4dda362 | Nits and Vermin (head) Gascoigne Infants 1300 119 6 Boys 1517 33 1 Girls 1212 187 7 North St. Infants 1001 61 4 Boys 767 18 1 Girls 650 82 3 Castle Infants Boys 486 64 2 Girls Creeksmouth Infants Boys 32 4 - Girls Westbury Infants 1196 99 2 Boys 701 18 2 Girls 986 109 2 Ripple Infants 1033 51 3 Boys 1136 28 4 Girls 1007 109 5 C. of E. Infants 570 79 1 Boys 635 41 3 Girls 633 210 7 RC. |
755b2003-fd61-424c-94e9-c53767932536 | Infants 607 80 7 Boys 620 53 — Girls Faircross — 349 29 1 Park Modern Mixed 708 9 — 13 During the year under review your nurses have striven really hard to try to get children's infested heads cleaned up at home, which, of course, is the right place for this work to be undertaken. This is reflected in the diminished number of cases which have been cleansed under arrangements made by the Local Authority. Before leaving this rather unsavoury subject, I want to make it perfectly clear that the greater part of the figures submitted to you of dirty people refer to children who are constantly dealt with and whom indeed it is sometimes impossible to keep clean because they are living with adults whose heads are literally crawling. |
a8c7fcfc-84af-466d-aa86-b90f6859020b | Indeed on one occasion not so long ago I had a parent protesting she could not possibly understand why her little girl could not keep her head clean, and I may mention that she was protesting so vigorously and shaking her head so firmly that I was mightily afraid she would shake some of the crawlers on to me, because her head was so full that they themselves could scarce find purchase. The work undertaken by your nurses is shown at the end of the appendix to this Report. Defective Footgear.—Cases of children with defective footgear were as heretofore referred to the Boots Minor Sub-Committee, who considered applications for the provision of boots in 159 cases, compared with 172 in 1927. In all 209 children were supplied with boots during the year. (b) Heights and Weights.—The following table gives the average heights and weights of children examined at the three undermentioned age periods in four of the schools, compared with the results at similar age periods in 1925, 1926 and 1527. |
90cf4896-bcfc-47c1-a8ed-79971544d2aa | Year. Average Height in Inches. Average Weight in Pounds. 5 yrs. 8 yrs. 12 yrs. 5 yrs- | 8 yrs. 12 yrs. |
7b3537cf-02d4-4735-9422-74b93ce8497f | 1925 42.1 49.05 56.5 41.1 54.1 78.8 1926 42.4 49.9 57.5 40.3 54.6 82.4 1927 42.2 49.3 57.1 40.6 52.5 80.1 1928 42.1 49.5 57.2 40.2 56.4 81.2 Average for 4 years 42.2 49.4 57.07 40.5 54.4 80.6 14 (c) Minor Ailments.—Although there is no significant alteration in the number of minor ailments found during routine inspections it is significant that a much larger number of children have actually been treated at your Minor Ailment Clinic. |
8d99df1f-5b1d-4b22-a213-55d64adf7a20 | It will be seen readily that this increase in work does not mean an increased incidence of minor ailments but that your children have, during the year under review, presented themselves in larger numbers than heretofore for treatment at your Clinic. The Clinic at East Street too has been used for a certain number of re-inspections, and many mothers have brought their children up during the year for advice for conditions other than those included under the heading " Minor Ailments." This has been of very considerable helpfulness to the children, to their parents and to you as an Education Authority, and development along these lines cannot but be beneficial to the town. (d) Skin Disease.—The common skin diseases include impetigo, septic sores, scabies, ringworm, etc. These showed on the whole a decline compared with previous years, and, although it is wrong to argue that these conditions occur only amongst dirty people, it is right to say that on the whole they are less frequent among cleanly than they are amongst people of indifferent cleanliness. |
348a4bc5-b222-4525-b994-23b76a5eadac | The treatment of impetigo is sometimes fought with much difficulty. In its most severe forms it occurs usually amongst children whose parents are indifferent to their condition. Rigorous medical treatment with ointment will cure these cases, but unfortunately without co-operation from the parents your work at the Clinic is brought to nought. Some of these intractable cases, so it is presently taught, are not true cases of impetigo at all but are really a very mild form of lupus. This has suggested the use of artificial sunlight in the cure of these cases and I have begun to use this form of treatment. Your artificial sunlight lamp, however, is of a form which does not lend itself to economic treatment in these cases and an extension of services will be necessary if we are to take up this work seriously. |
0de21b2d-e8d0-4ab6-97fb-26d4e8660f54 | 15 (e) and (/) Eye Disease, Vision and Squint.—With reference to the findings of School Medical Inspection with regard to eye diseases, I have to report that on the whole, with the exception of defective vision, including squint, these diseases have shown a decrease. These diseases, too, tend rather to manifest themselves amongst communities that are not particularly devoted to hygiene, so that here too your figures give a reassuring message that, generally, personal cleanliness is being more and more appreciated by the parents of the children attending your schools. With reference to the increase in the number of cases of defective vision found and the number of cases of squint, I am unprepared at the present time to make any serious statement, but perhaps I might suggest that the total number of children of the intermediate code group examined this year was considerably in excess of that for last year, and that it is amongst these children defects of vision are chiefly discovered. |
bf230386-7ffd-4b5e-9401-59a8450d4ded | It will be noted that there were no less than seventeen cases of squint found requiring treatment among the schoolchildren during the year 1928. The corresponding figure for last year was seven. These cases of squint are naturally found chiefly among the children who are entrants. The number of these cases is sufficient to indicate the wisdom of the Council in deciding to take up refraction work for children , under school age. (g) Ear Disease.—The condition of your children with regard to ear disease remains practically as it was last year. It will be a long time before we deal effectively with this problem, which is intimately associated with the kindred problem of enlarged tonsils and adenoids, with which I am dealing in the next paragraph of this report. (h) Tonsils and Adenoids.—There is a decrease this year in the number of cases of tonsils and adenoids found, but, although this decrease is material, it is by no means sufficient to make the problem anything other than a very grave one. |
d17a65de-e3fc-4a1b-a384-03e3f17d6ca5 | Nature never intended such a vast number of children to have tonsils and adenoids which are interfering with their growth and development. 16 I want to make it perfectly clear that enlarged tonsils (these are glands at the back of the throat) and enlarged adenoids (i.e. an overgrowth of a loose tissue at the back of the nose) are not in themselves looked upon as warranting surgical interference. The Board of Education has very wisely unified our views on the subject by explaining very carefully the conditions under which surgical interference should be recommended, and, avoiding all technicalities, it may be said that these conditions virtually mean the tonsiL and adenoids should only be taken out if and when these structures are definitely interfering with the growth and development of the child and/or are so diseased as definitely to interfere with the health of the child. |
fbbcbacd-9ab4-42ec-994d-7c53b903da9c | One thing learnt in our Infant Clinics is that the problem of health amongst young children is essentially a problem of right feeding, and I feel sure when we have mastered the principles of right feeding amongst children the surgical treatment of tonsils and adenoids will be considered a definite indication of the ignorance of the age in which we live. A technical discussion on this point would be out of place, but I will go so far as to say that we are reasonably assured that development of the type of tissue found in tonsils and adenoids is due to a diet in which there is an excess of starch, or at least an amount of starch in excess of the vitamin which is found in the germ of wheat. It may seem a far cry-from the question of white bread to the question of the prevention of tonsils and adenoids, but I feel it will be only by means of an enquiry into the subject from this standpoint that we shall do away with our present necessary and necessarily barbaric methods of dealing with a common ailment of children. |
af0e000d-3bbf-41e8-9e75-401fdb201489 | Although it is premature to express a considered opinion, it does seem, not only from the statistics but from our general personal observations, that defective tonsils and adenoids do not constitute quite the same problem that they did even a few years ago, and I am happy to be able to say that, although I am not prepared quite to prove my words, I do believe that this is due to the work in our Maternity and Child Welfare Clinics, where a considerable amount of time is spent in teaching mothers the hygiene of the mouth and of the nose, and in teaching mothers the value of right feeding. 17 May I this year again call your attention to the fact that adequate facilities at either of the hospitals to which you send cases do not exist for the over-night detention of all children after operation. It is my considered opinion that all these cases should be retained in hospital after this operation, which, after all, is by no means a minor one. |
e966d886-eae2-4d0c-a9bb-bff0b049b178 | It is estimated that this practice will treble the present cost of this service—perhaps increase it four-fold; and, indeed, when hospital services are put on a sound financial basis the increase in the future will be even greater. I do, however, look upon this change, involving whatever expenditure it does, as essential. («) Tuberculosis.—There were 14 cases of tuberculosis amongst children of school age notified to the Medical Officer of Health during the year. The total number of attendances by your school children at the dispensary amounted to 377 during the year under review. It has been my care, so far as possible, to examine children away from the dispensary. {j) Dental Defects.—The findings at medical inspection leave no doubt that the work of your dental officers is making itself felt. The dentition of children among the school-leaving group is creditable compared with what it was even five or six years ago. |
246e3d51-244d-49e4-bfe1-ae141b3d6f9f | (k) Crippling Defects.—With reference to crippling defects, by which I am referring to those children who are classified as being subjects of deformity in Table 11, I would like to say that, although the figures have increased, actually there is a very considerable improvement, especially in the minor disabilities such as curvature of the spine. Although from a surgical standpoint the lesser degrees of curvature of the spine must be looked upon as minor disabilities, there is no doubt that actually this curvature of the spine is often the cause of a loss of efficiency apparently out of proportion to the actual physical disability, and that therefore a general improvement in these minor disabilities means a general improvement in the efficiency of your school services. 18 (6) INFECTIOUS DISEASE. The prevention of the spreading of infectious diseases in your schools is carried on by the united efforts of the teachers and your public health staff. Notified cases are followed up, and, so far as is practicable, steps are taken to minimise the possibility of infection at school. |
142cbe8e-5aaa-4713-a075-ee4c17fa3396 | The difficulties, however, are very considerable. The beginnings of most infectious diseases are so vague that if every child who suffers from a sore throat were forthwith advised to stay home, not only would many children remain away from school with very minor disabilities, but any child who wished to remain off school would have a ready-made excuse, well nigh impossible to disprove. It is remarkable under these circumstances how very much is done by our teachers. In cases of notifiable infectious disease the sanitary inspectors call at the home, make all possible investigations, and on their report, if necessary, your medical staff take further action. As you know, where the attendance of a school falls below 60 per cent., and in the opinion of the Medical Officer this bad attendance is directly due to the prevalence of an infectious disease, the school sessions so affected are not counted in estimating the average attendance for the purpose of grant. |
c169d375-4e66-42f1-9d14-81c5d75d0a6a | The following table shows briefly the number of children notified and reported suffering from some of the commoner infectious diseases:— Scarlet Fever 132 Diphtheria 67 Measles and German Measles 342 Chicken-pox 215 Whooping Cough 47 19 (7) FOLLOWING UP. A summary of the "following up" work undertaken by your school nurses is given herewith:— Number of visits to schools 219 Number of visits to schools for medical inspection 131 Number of home visits in connection with— 1927. 1928. (a) Routine medical inspections 3,419 3,345 (b) Infectious disease 137 571 (c) Uncleanliness inspections 251 212 (d) Non-attendance for treatment, etc. 367 542 It will be noted that the home visits in connection with routine medical inspection are slightly lower than last year, but that, contrariwise, those with regard to infectious disease .and nonattendance for treatment are very much higher. |
8a489832-5f89-4134-b1cf-6c278e33f1b4 | The arrangements for following up have not been materially altered during the year 1928. <» Clinics.—The numbers of school children attending in 192 were as follows:— Clinic. No. of 1st attendances of children. Total No. of attendances Minor Ailments 2059 12749 Ophthalmic 128 559 Dental 1852 2787 Ringworm 9 18 Orthopaedic FOR EXAMINATION 29 2427 FOR TREATMENT 62 Minor Ailments Clinic. No. of days clinic was open 302 Total No. of attendances 12749 Daily average attendance 42.2 No. of cases treated 2059 20 (8) MEDICAL AND SURGICAL TREATMENT. Minor Ailment Clinic.—Minor ailments are treated daily at the Clinic at East Street. Three nurses attend from the Plaistow Maternity Charity, and the Clinic is opened at 8.30 a.m. |
d7f3fdb2-ef45-48b3-acdb-f87eb6080f8d | During the year, on three half-days a week, one of these nurses has taken the place of the Dental Nurse, and has been in attendance on the dentist; and has also been in attendance, together with the Dental Nurse, on the mornings when there have been gas sessions. That this Minor Ailment Clinic is capable of meeting a very real need, for which there is a demand, is seen from the figures for the current year. It will be noted that the attendance was nearly doubled. This is due to the fact that the term " minor ailment" has been generously interpreted, and without in the least encroaching on the realms of private practice it has been found a large amount of work can be done to the benefit of the scholars of the town and to their parents. |
adab272c-e21f-47b0-9aab-64958e5d8516 | This has meant time, not only for the work to be done, but for it to be co-ordinated, and I very much regret that with our available medical staff the Minor Ailment Clinic cannot take the place it could take, and in my opinion cannot undertake the work it should undertake. Not only have we undertaken work prescribed by ourselves, but in many cases children have attended the large London hospitals for advice, and, by arrangement, we have carried out the treatment they have prescribed, to the considerable financial advantage of the parents of these children. Tonsils and Adenoids.—Operations for the surgical treatment of tonsils and adenoids are carried out by arrangement with Queen Mary's Hospital, Stratford, and St. Mary's Hospital, Plaistow. I have indicated to you in a previous part of the report how necessary I think it is to revise the present contract so that it shall include the detention of these children following operation. |
87476e3a-e161-4c2f-b7c9-327a777ae9ae | 21 Tuberculosis.—The care of tubercular children as such is entirely in the hands of the County Council, but every effort has been made to co-ordinate the amenities available under your own and under the County Council schemes. The present position with regard to surgical tuberculosis is rather open to criticism. A child is seen at the County Dispensary by me ; if necessary, it is sent to Sir Henry Gauvain, as the county specialist, and a report received by me. The child may then be sent to Alton or some other similar institution, after which it is returned to Barking and most probably will then attend the Open-Air School, where, so far as you as a local authority are concerned, Mr. Whitchurch Howell is in charge of the case for all educational purposes; but, nevertheless, the county are still responsible for the case if for any reason attendance at school is discontinued. |
d9a6a35b-82d6-4e2a-991d-abc478875a63 | This overlapping is further augmented by the fact that oftentimes these and similar cases are taken by the parents to the large London hospitals, and the whole question calls for discussion, because unquestionably there is quite a lot of misdirected effort which could be used for more useful purposes. Skin Diseases.—With reference to the treatment of skin diseases, I have already indicated that further amenities are desirable for the treatment of intractable cases of impetigo. The treatment of ringworm is satisfactorily carried on by X-ray, and you yourselves have provided amenities for treating cases of scabies. It is, perhaps, in the treatment of skin diseases that the lack of continuity of supervision at the Minor Ailments Clinic is most felt. Thus children are often On the books here for an unconscionable length of time. The nurses at the Clinic are provided by rota by the Plaistow Maternity Charity ; both your medical officers take the Clinic from time to time, and there is no continuity of supervision. |
0ec2a810-e724-47ee-8c8d-f384a4dd98a3 | Add to this the system of record keeping does not facilitate the 22 history of any one child being rapidly brought before the officer investigating the case, and you will see it is an easy matter for a child to attend longer than it should have to attend, and that it is a difficult matter in the time available to prevent them from so continuing to attend. External Eye Disease.—It will have been noted that external eye disease is to some extent associated with indifferent home circumstances, and I have noted with pleasure the general improvement taking place in the last few years in the home conditions of the little patients who constitute the group of children that come up for diseases of the external eye. This is fortunately reflected in the fact that it has been noted now for the past year or so that, with the exception of a very small number of intractable cases, these conditions have proved themselves more amenable to the simple treatments carried out at the Minor Ailment Clinic than hitherto. |
9ab6945d-4867-4e14-98ed-f9d0b1b917de | It has never been necessary to refer any large number of these cases whatsoever to hospitals for special treatment. This means a considerable saving in money and time to the parents, and of course a similar improvement in the efficiency of school life. Vision.—The treatment of defective vision is carried out on Saturday mornings at the East Street Clinic. The pupils of the children's eyes are dilated, and refraction is carried out. It is only when children's eyes are so dilated that refraction can be carried out properly, and although this does mean that for a few days the children themselves cannot see so well as usual, and this interferes with their school work, it is an interference no one yet has found a means of mitigating. We had hoped during the present year to be able to carry out on Saturday mornings also a certain number of special appointments of children referred to the clinic from routine inspection, and otherwise in whom complete examination could not be carried out at school. |
497ade62-3506-4463-a01e-3e8b632b696f | This attempt, however, seriously interfered with the eye work, which is somewhat behind. I regret these special appointments will have to be curtailed. 23 Ear Disease.—The most common ear disease with which we have to deal is the ordinary discharge from the external ear. The treatment usually employed is that of putting in special drops which tend to lift the corruptible matter from the bottom of the ear. This is followed by thoroughly cleansing the ear, which is afterwards dusted with a special preparation of thioform. This method of treatment has been found reasonably satisfactory, but the period of invalidity and incapacity, i.e., the period during which the children are oftentimes off school, could materially be decreased if we could offer the more up-to-date electrical treatment known as ionisation. The introduction of this treatment could be undertaken for a very modest expenditure of money, and is only really a question of providing the necessary time for your medical officers to carry it out. |
3176c406-435e-4708-a680-f49d0ce0ab93 | This extra time would be required because, whilst the present treatment is carried out by your nursing staff, the electrical treatment would require the constant attendance and supervision of a medical officer. Dental Defects.—Dental defects are very adequately dealt with at the Dental Clinic. The work at this Clinic is set forth in detail in a report by Mr. Smyth. Crippling Defects and Orthopaedics.—" Crippling defects" within the meaning of the Board of Education has rather a wider application than is usually understood by this term. It includes severe cases of heart disease. With special reference to crippling defects that come under the heading of orthopaedics, I may say these are dealt with bv your consultant, Mr. Whitchurch Howell, who holds a Clinic at Faircross one half-day a month. Miss Findlay carries out the prescribed treatment on three days a week. This work is very highly appreciated by parents and teachers, and I know that you value it highly. |
d53efd14-7db9-40d3-884c-7d7ac3a1f93d | The time has come when an extension of these services is urgently required, and you have quite enough work for the services of a whole-time nurse. You 24 could achieve this end by either employing a special orthopaedic nurse for the whole week or, by arrangement with a neighbouring authority, employing two nurses for three days a week. With the amenities you have available at Faircross, undoubtedly the former would be rather more practicable than the latter ; although, if the Tatter procedure were adopted, it would mean that you could retain the services of your present masseuse and have an assistant nurse to work with her. The question of the provision of this extra service is intimately linked up with the extension of the medical service as a whole, and, although highly desirable, I do not advise it until the general extension can be undertaken as well. In necessary cases, children are sent by you to Brookfields Orthopaedic Hospital where they still remain under the care of Mr. Whitchurch Howell. You pay £2 2s. |
e4f1c6fc-1e08-4cf6-a359-a7c3c39347d7 | a week for this form of treatment. There appears to have been a general impression that these cases could only remain in Brookfields Hospital for short periods of time, whereas, during the year under review, we have had in one case for the whole of the year. The cost to the authority has been very considerable, and of course your special services will cost you considerable while you very rightly undertake such necessary work as this. There is at the present time a lack of co-ordination between various hospitals, and one child may during the course of treatment come under two or three surgeons, as the parent moves from hospital to hospital according to necessity or choice. In cases such as these children present, where continuity of treatment over oftentimes a long period of years is essential to success, this is to be deprecated, and co-ordination is a matter of pressing moment. |
ab302b15-3cba-4d9d-9c47-c84b8fe1e4b7 | Mostly this is a matter for the hospitals themselves, in which the local authority, although vitally interested, has no opportunity of expressing an opinion; but in one particular instance the question does essentially lie within the purview of the local authority and of the Essex County Council. 25-26 PARTICULARS OF WORK DONE IN CONNECTION WITH ORTHOPÆDIC CLINIC. No of visits by Orthopædic Surgeon No. of visits by Masseuse ATTENDANCES Primary Examination Re-Examination For Treatment Total School Children Under School Age School Children Under School Age School Children Under School Age TREATMENTS Massage Electricity Remedial Exercises Ultra Violet Therapy Radiant Heat Dressings and Splintage No. of Children No. of Treatments No. of Children No. of Treatments No. of Children No. of Treatments No. of Children No. of Treatments No. of Children No. of Treatments No. of Children No. |
e9a4e360-3076-4bff-943e-de943535cba0 | of Treatments School Children 3 123 1 1 34 1462 24 878 - — 1 37 Under School Age 6 310 — — 2 62 63 757 — 5 121 Admission to Orthopedic Hospitals On waiting List for Admission 31/12/28. School Children Under School Age Total School Children Under School Age Total 6 3 9 1 " 1 2 27 This I have already dealt with in reporting on the case of children the subject of surgical tuberculosis. My submission is that the time is overdue for a conference between all the hospitals engaged in orthopaedic work and the local authorities who are financially or otherwise interested in that work. (9) OPEN-AIR EDUCATION. Playground Classes.—Barking is fortunate in having some schools built in a modern style of architecture on sound, practical, sanitary lines ; but, on the other hand, some of the schools were built, not wisely, but too well. |
165bd238-399e-452e-8ebb-88625981438b | They are gaunt premises, built rather as places of monastic seclusion for the forcing of intellect than places of health-producing educational activity. In these factories of education it is desirable that every opportunity should be taken of conducting studies in the open air, and the desirable point of view is that all classes should take place in the open air unless the climatic conditions prohibit it, or the special nature of the work demands that it should be done indoors. School Journeys.—School journeys, as such, are not a feature of school life in Barking, but their place is more than satisfactorily taken by the numerous school camps which are held, and the holiday camps which are run during the summer vacation. These school camps are admirable features of your educational activities. Children go out on Friday evening and come back on Monday evening. At Hainault t hey live an open-air life, and many of the children, by means of these camps, spend a day or two in the country for the first time in their lives. |
7a181525-f690-4fab-8ba0-8c73c42a6898 | All the girls and boys are medically examined before they go, and only in one instance has it been necessary for me to send a child home from Hainault. The summer camps during the holidays are of a fortnight's duration each, and here again every child is fully examined before he or she leaves Barking. Particular stress is laid on the condition 28 of the throat; general cleanliness is insisted upon, and all the children are specially examined to make sure they are quite fit to stand the rather vigorous life they naturally live during their holidays. Open-Air Classrooms in Public Elementary Schools.—At the Park Modern School it is possible to turn the rooms into modified open-air classrooms, and this school and the Open-air School should be looked upon as standards of school architecture for the future. Of course, St. Joseph's School is also a school recently built on modern lines, and I do hope we shall see no more schools of the factory type. |
b6d71de3-f4ac-45de-a45d-8807ba2357bd | Ultra Violet Light Treatment.—Ultra violet light treatment has been carried out at Faircross School during the year, the total cases treated being 34. The period of treatment of these cases varied from one month to twelve months and the total number of doses was 872. Children diagnosed as suffering from Tuberculous Glands, Alopaecia, Rheumatism, Anaemia, Debility, Impetigo and Cervical Adenitis are among those who have derived considerable benefit from this treatment. (9) OPEN-AIR SCHOOLS (e) The Open-air School at Faircross is one of the most valued possessions of the Local Authority, and I naturally regret that we have lost one classroom, which is now being devoted to ordinary elementary education. |
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